The Breakdown: What does the data say about behavioral health programs?



By Dr. Sanjay Basu

“The Breakdown” is a series examining the latest developments in health and wellness, sharing what the research says about some of today’s most pressing issues, what it doesn’t, and where we still have more work to do. At Collective Health, we take a rigorous approach to our research to ensure we’re making informed decisions that improve the health of our members. In “The Breakdown,” we’ll share the insights we’ve learned through that process. You can read more about our approach in STAT.

“Behavioral health” has become an ever-present label in employer health, given increased attention to burnout, depression, insomnia, and addiction among employees. But while 70% of employers say they plan to take action on behavioral health, 45% haven’t taken any action nor have any actions planned to address issues around behavioral health. That’s an understandable contradiction; currently, the data on program effectiveness is ambiguous or anecdotal, and insurance reimbursement policies often fail to reflect best practices. But recent studies do point to strategies that employers could use to strategically invest their behavioral health dollars.

Consider integrating behavioral health services with primary care

Behavioral health offerings are often distinct from other forms of care, but our analyses suggest that closer integration between behavioral health and primary care—in what is called the “collaborative care model”—may be most financially sustainable. Because people with behavioral health problems tend to visit a primary care physician to discuss these problems more commonly than a psychiatrist or counselor, the primary care backbone may offer more opportunities for action.

The takeaway for HR and benefits leaders:
Look at your overall care model. How do your behavioral health offerings integrate with primary care benefits? The more connected your offerings are, the more likely they are to reach more members in a cost-effective way.

Cognitive behavioral therapy (CBT)-based programs can help individuals and organizations

Cognitive behavioral therapy (CBT) programs are helpful for stress management, depression, and anxiety, among other conditions. The programs can help produce a marked reduction in symptoms and stress levels. Clear, evidence-based organizational and individual benefit has been observed with return-to-work programs that integrate CBT strategies.

The takeaway for HR and benefits leaders:
Make sure your organization’s behavioral health benefits include CBT. You can scan your provider directory to see what services your covered providers are offering. There are CBT-based digital health solutions that may be able to help expand your behavioral health coverage.

Briefings following traumatic workplace events are ineffective

While traumatic events in the workplace are—thankfully—uncommon, it’s important for organizations to react accordingly when one does occur. Historically, that process has included a psychological debriefing—an immediate intervention intended to reduce stress and long-term effects of trauma. Yet evidence suggests that these briefings may be ineffective and can actually produce adverse effects among particularly sensitive employees. Rather than being debriefed in the employer setting, employees should be offered formal out-of-office psychiatric therapy.

The takeaway for HR and benefits leaders:
Do you have a plan for what to do if a traumatic event occurs in your workplace? If not, now’s the time to get started on one. And while traditional recommendations have suggested incorporating on-site debriefings into that process, consider other options like covering off-site counseling services.

Integration is key with opioid addiction and suicide prevention efforts

Only 22% of employers currently have or plan to implement programs that address opioid use and suicide prevention in 2019. While many employers don’t consider these aspects of behavioral health programs, these problems are affecting increasingly large segments of the American workforce. We’ll talk more about opioid addiction programs in a future post.

The takeaway for HR and benefits leaders:
Addiction services and suicide prevention are major components of behavioral health services; benefits programs you offer should address them explicitly.

It’s likely that behavioral health will continue to be a pressing topic in employer health. And as more studies on the quality of treatment programs are published, it’s critical that employers continue to adjust their programs to ensure their employees are getting the behavioral healthcare they need.

In future articles, I’ll share the latest updates on health and benefits-related topics from some of the industry’s leading journals. Sign up for our email newsletter to get more information like this in your inbox.

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